The clinical use of contrast-enhanced ultrasound in the kidney

Traditional B-Mode and Doppler sonography have been the stalwart of renal tract imaging for many years, and indeed, are in daily use in most centres as the modality of choice for the initial assessment of renal pathology. However, traditional ultrasound scanning can be limited in its ability to accurately characterise renal pathology, and can be inaccurate at determining benign from malignant lesions. Contrast-enhanced ultrasound conveys many benefits, being safe (especially in patients with renal dysfunction), does not require the use of ionising radiation, is quick and relatively cheap and can help to establish whether a focal renal lesion is sinister. Furthermore, it is our experience that contrast-enhanced ultrasound is not a difficult technique to master for the experienced ultrasound practitioner. In this article, we discuss the technique, interpretation and value of contrast-enhanced ultrasound in renal imaging, and describe how we use it in our practice.